Five critical areas in health care today

Put your political persuasion aside and let’s get down to some of the really critical issues facing all of us here in the Bluffton area. Please try to forget whether you are a Democrat or Republican, conservative or liberal or whatever. Understand we are all human beings first and foremost.

Yes most of us will get sick on occasion, have unfortunate accidents and are vulnerable to all sorts of health problems, especially as we grow older. We like the emphasis on prevention, but when the above occurs, we want to get well, live as comfortably as possible with our chronic diseases, and be able to afford the costs charged by insurance, whether government or private. But this latter desire is extraordinarily difficult, complex, controversial, and frankly, very scary for us, our children and grandchildren.

So I have picked five important areas that I believe to be critical. There are many more, but we need to concentrate on the following:

1. Pre-existing health conditions. This issue can affect nearly all of us. Insurance companies have for years, used pre-existing condtions as a means to deny legitimate claims, causing major family stress, and basically making the insurance companies very rich at the same time.

2. Monetary caps on total, lifetime insurance. The facts are that medical charges, especially hospital and certain specialty care, are so expensive, individuals could reach their cap before they are even in their teens, with a long lifetime and medical costs ahead.

3. Uninsured people have to be insured. Now don’t get upset until you understand that the reason for this is not political, it’s financial and basic fairness. Most people don’t want the government mandating them what they have to do or, let alone, purchase. But the fact is, government, at all levels have been doing just that since 1776. I hate seat belts; I got fined some years back, for not having one on my aching back that hurt when forced back on the seat. But that’s life. What is not right and not understood is that every time a non-insured person gets treated in the ER, we, you and I, pay for it over and over again. Those costs are passed on to everyone and I am talking about the uninsured who can afford the premiums, but don’t want to pay. I guess they believe they will never get sick or hurt. American hospital ER’s, by law, must treat anyone requesting care. In this regard, you may want to be “your brothers keeper,” but not me and government has nothing to do with it. I’ll repeat this very misunderstood and critical mandate issue in future columns.

4. Young people need family coverage. Hopefully, when the economy improves, this won’t be a big problem, but it is, at present. Young people graduating high school, college, technical school or higher degrees, can’t get jobs or insurance re: Their education or skills. They are mostly ages 18–26 and often living at home. Their parents are paying premiums for family policies so these men and women should be covered. I don’t understand why this is, in anyway, controversial.

5. Should employers be required to insure employees. This appears to be the most controversial and difficult of all the mandates, but not in my judgment. To me it is a marketplace situation, pure and simple. Benefits, especially today, are important to job seekers. Companies and businesses, regardless of size, have to decide whether or not to make health care insurance part of the “goodies” package. If they can’t afford it, so be it and the recruit will have to decide. Marketplace principles have always taught “you get what you pay for.” As for now, shared costs seem to be the future.

These are the big five that Obamacare does cover, and if repealed, the Republicans will have to take care of these quickly. There are many other issues. For instance, proper and reasonable reimbursements for all providers based on quality; the problem is quality “is in the eyes of the beholder.” And the eyes of the patient, the provider, the hospital and the insurance company can be quite different. Webster’s definition for quality is — “peculiar and essential character; degree of excellence; superiority in kind; an acquired skill; a distinguished attribute”.

Most politicians tell us we have the best health care system in the world. Do we? I think we probably do technically, if and it is a big if, a person can afford it. Many, too many, cannot. U.S. health care costs more that any Western nation and the statistical results are mediocre. This, above all else, is the real issue and where true reform is an absolute. Most everyone agrees on this, but can’t or simply won’t take the necessary measures to accomplish this reformation. Sometime, somehow soon, we had better get started.

Columnist Mike Silver lives in Pinecrest and may be reached by email at michaelsilver@hargray.com or by calling 843-815-3894.

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